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General NPI Number Information
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NPI Number | 1730407362
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Entity Type | Organization
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Legal Business Name | RCHP - OTTUMWA LLC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 1001 PENNSYLVANIA AVE
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City | OTTUMWA
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State | IA
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Zip | 52501-6427
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Country | US
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Telephone | 641-684-2300
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Fax | 641-684-2363
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Provider Business Mailing Address
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Address Line | 1001 PENNSYLVANIA AVE
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City | OTTUMWA
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State | IA
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Zip | 52501-6427
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Country | US
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Telephone | 641-684-2300
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | STEPHEN L. PAGE
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Credential |
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Telephone | 615-844-9849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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